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Nitazene drug warnings prompt action from TGA

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25th September, 2023

The work of NSW Health Pathology’s Forensic & Analytical Science Service laboratories has been recognised by Australia’s health watchdog, as it moves to restrict the use of a dangerous class of drugs.

The Ther­a­peu­tic Goods Admin­is­tra­tion is act­ing to restrict the use of potent syn­thet­ic opi­oids known as nitazenes that have been the sub­ject of recent warn­ings by health author­i­ties in NSW, the ACT, and Victoria.

The TGA deci­sion not­ed that “pub­lic expo­sure appears to be entire­ly recreational…and their abuse and illic­it use pos­es a sig­nif­i­cant risk to pub­lic health”.

The TGA del­e­gate fur­ther not­ed that the nitazene fam­i­ly of sub­stances were orig­i­nal­ly devel­oped with the inten­tion to be used in anaes­the­sia, but the poten­cy of the sub­stances and asso­ci­at­ed risk of res­pi­ra­to­ry depres­sion and death means “they are con­sid­ered unsuit­able for use in a ther­a­peu­tic context”.

“I also recog­nise that there are increas­ing reports of the pres­ence of these sub­stances in drugs intend­ed for recre­ation­al use, which has result­ed in a pro­por­tion­ate increase in adverse events and fatal­i­ties asso­ci­at­ed with expo­sure to nitazenes,” the del­e­gate said.

“While these reports are large­ly lim­it­ed to over­seas juris­dic­tions thus far, I note with con­cern the recent reports of the detec­tion of nitazenes in seizures of hero­in and oth­er illic­it and coun­ter­feit drugs in Australia.”

White powder inside a mortar and pestle, being held by blue-gloved hands.
NSW Health Pathol­o­gy’s illic­it drug test­ing lab­o­ra­to­ries have played a cru­cial role in iden­ti­fy­ing nitazenes.

The Foren­sic Tox­i­col­o­gy Lab­o­ra­to­ry and Illic­it Drug Analy­sis Unit (IDAU) at NSW Health Pathology’s Foren­sic & Ana­lyt­i­cal Sci­ence Ser­vice (FASS) are work­ing in part­ner­ship with sev­er­al oth­er agen­cies to ensure the safe­ty of the com­mu­ni­ty when it comes to illic­it and oth­er drugs of abuse.

The Com­bined Sur­veil­lance and Mon­i­tor­ing of Seized Sam­ples (CoS­MoSS) project, which includes the IDAU, NSW Police, and the NSW Min­istry of Health involves analy­sis and report­ing on street lev­el drugs seized by NSW Police.

The Pre­scrip­tion, Recre­ation­al and Illic­it Sub­stance Eval­u­a­tion (PRISE) pro­gram is a col­lab­o­ra­tion includ­ing FASS Foren­sic Tox­i­col­o­gy, NSW Poi­sons Infor­ma­tion Cen­tre and the NSW Min­istry of Health pro­vid­ing expe­dit­ed com­pre­hen­sive tox­i­co­log­i­cal test­ing for patients with severe or unusu­al sub­stance relat­ed toxicity.

The organ­i­sa­tions recent­ly col­lab­o­rat­ed to issue a pub­lic drug warn­ing that iso­toni­tazene has been detect­ed in ‘hero­in’ seized on the NSW Cen­tral Coast. The drugs had been linked to sev­er­al over­dos­es and ICU admissions.

FASS Direc­tor Michael Symonds said the TGA con­sid­ered the drug alert issued by NSW Health in mak­ing its deci­sion on nitazenes.

“This is great recog­ni­tion of the work being done by our Foren­sic Tox­i­col­o­gy and Illic­it Drug Analy­sis teams and shows that our focus on sur­veil­lance and keep­ing com­mu­ni­ties safe is work­ing,” Mr Symonds said.

“Nitazenes are a par­tic­u­lar­ly dan­ger­ous syn­thet­ic opi­oid and require time-con­sum­ing lab work to trace.

“The poten­cy of nitazenes means dos­es are small and it can be present in extreme­ly low con­cen­tra­tions in drug and bio­log­i­cal samples.

“But our lab­o­ra­to­ries have been able to detect even small quan­ti­ties of this dan­ger­ous drug.”

The TGA deci­sion to restrict nitazenes will come into effect from 1 Octo­ber 2023 and comes just months after the UK announced sim­i­lar restric­tions.

A man wearing a black suit and blue tie, smiling.
FASS Direc­tor Michael Symonds.


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